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Introduction
Nurses who work with cancer patients undergoing chemotherapy face a significant risk of occupational exposure to dangerous substances. Safe chemotherapy handling practices are essential to ensure the safety of nurses. The study by Colvin, Karius, and Albert (2016) examined the difference in subjective and objective adherence to safe handling guidelines among chemotherapy nurses. The present paper will seek to summarize and analyze the information from the research study, as well as describe its implications for evidence-based nursing practice.
Research Question
The research sought to compare the nurses awareness of their compliance with safe chemotherapy handling practices. The research question is not stated in the article, but the study is focused on the question What are the differences between the nurses subjective perception of their compliance with safe handling guidelines and their actual level of compliance? . This question was prompted by the increased threat of occupational exposure among nurses who care for cancer patients. According to Polovich (2016), occupational exposure to dangerous agents threatens the health and safety of nurses. Thus, the research question is appropriate to the chosen field of study and could affect nursing practice in oncology.
Research Design
The research used a mixed-methods design, with ethnographic study and questionnaires as the main tools for data collection. A mixed-methods design is beneficial because it allows yielding the benefits of both qualitative and quantitative approaches to research. Here, ethnographic study enabled to evaluate compliance objectively, whereas questionnaires aided the researchers in observing common ideas and trends in subjective opinions of nurses.
Two particular weaknesses of a mixed-method design are that it takes more time and effort and requires more resources, such as human resources, funding, equipment, and data analysis tools. It is possible that the authors chose a mixed-methods approach despite these considerations because it suits the goal of the study and can help to create a comprehensive analysis of the problem.
Sample
The study was set in a quaternary care medical center with 76 ambulatory oncology infusion treatment chairs. The sample size consisted of 33 nurses, and 12 nurses working in the medical center submitted self-assessments. Both the sample size and the number of participants in the study is rather small, as it is not possible to generalize the results obtained from 12 nurses to all other nurses working in oncology. In addition, as half of the study relied on quantitative data from questionnaires, such a small sample was inadequate to identify significant trends. Based on the goals of the study and the research design, the recommended number of participants would be at least 40-50 nurses.
Data Collection Methods
The researchers used two separate data collection methods: micro-ethnography observations and questionnaires. Micro-ethnography observations were conducted by three observers who fit the criteria for experience and qualifications. Surveys were disseminated and analyzed by researchers and completed by nurses independently. The only ethical consideration that was addressed by researchers was data confidentiality.
The researchers did not record the participants names and used sealed envelopes for questionnaire submission. The authors do not describe whether or not ethics board approval and informed consent were obtained, which is the primary gap of the study. Approval of a study by an ethics board ensures that the research conforms with all major ethical requirements, whereas informed consent shows that all participants are aware of their participation in the study and allow researchers to access the data about their activities and skills.
Limitations
Determining and discussing the limitations of a study helps to identify whether or not the results can be generalized to other populations and applied in practice. Based on the analysis, the study had two significant limitations. Firstly, the sample size was too small to allow for generalization. Secondly, the study did not address some ethical considerations, such as privacy and informed consent. Both limitations are important, as they influence the authors conclusions and the possibility of replicating the study. To fill these gaps in subsequent studies, it would be critical to obtaining informed consent and approval of an ethics board, as well as include more participants in the research.
Findings
The study found that nurses overestimated their use of double gloving and work surface protection during administration and underestimated the frequency of double gloving, proper disposal, and gowning after administration. The findings are appropriate to the goal of the study and answer the primary research question. The credibility of these findings is rather high due to the chosen research design and objective data collection methods. However, due to the small sample size, it is not possible to extend these conclusions to other nurses working in similar settings.
Summary
All in all, the research question and design were found to be appropriate to the goal of the study. The two main limitations of the research are the sample size and the fact that the authors did not address important ethical issues. The findings of the study answer the proposed research question, although the possibility of generalizing the findings is limited. Judging from the analysis of the study, the evidence is not strong enough to suggest a change in practice.
In order for a study to contribute to evidence-based practice, it is critical to use a large study sample and fulfill all the ethical requirements to ensure validity and reliability of results. Nevertheless, a similar research design can be used in a large-scale study that would fill the gaps identified in the analysis and would help to confirm the authors conclusions.
References
Colvin, C. M., Karius, D., & Albert, N. M. (2016). Nurse adherence to safe-handling practices: Observation versus self-assessment. Clinical Journal of Oncology Nursing, 20(6), 617-622.
Polovich, M. (2016). Minimizing occupational exposure to antineoplastic agents. Journal of Infusion Nursing, 39(5), 307-313.
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